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Objective:To analyze the perioperative clinical characteristics of patients with oral cancer underwent radical resection and flap reconstrution and the nursing managements.Methods:From January 2020 to December 2020, 658 patients with oral cancer underwent radical resection and flap reconstrution in the Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University were retrospectively analyzed. All patients were divided into the elderly group (≥60 years) and the younger group (< 60 years), including 279 cases in the elderly group and 379 cases in the younger group. The perioperative clinical data of the patients were collected, and the perioperative general situation, postoperative complications and influencing factors of complications were analyzed.Results:There were differences between the two groups in the aspects of sex ( χ2 = 12.38, P<0.001), preoperative BMI ( t = 2.43, P = 0.015), smoking history ( χ2 = 18.34, P<0.001), preoperative anesthesia grade ( χ2 = 25.61, P = 0.001), preoperative coexisting disease ( χ2 = 46.97, P<0.001), whether oral floor or tongue cancer ( χ2 = 16.68, P<0.001), whether free flap ( χ2 = 6.81, P = 0.003), operation time ( t = 2.19, P = 0.029), preoperative test index hemoglobin ( t = 4.96, P<0.001), albumin ( t = 5.44, P<0.001), D-dimer( Z = -13.52, P<0.001), calcium levels ( t = 4.07, P<0.001) and postoperative complications ( χ2 = 14.55, P<0.001). Multivariate analysis of postoperative complications showed that the age ( OR = 1.021, 95% CI = 1.005-1.037, P = 0.011), preoperative D-dimer ( OR = 1.219, 95% CI = 1.026-1.447, P = 0.024) and the preoperative coexisting disease ( OR = 1.642, 95% CI = 1.108-2.432, P = 0.013) were the risk factors for the postoperative complications. Multivariate analysis of discharge with tube showed that the age ( OR = 1.017, 95% CI = 1.003-1.031, P = 0.017), preoperative BMI ( OR = 0.917, 95% CI = 0.873-0.963, P = 0.001), whether oral floor or tongue cancer ( OR = 2.135, 95% CI = 1.475-3.091, P<0.001), and operation time ( OR = 1.220, 95% CI = 1.120-1.328, P<0.001) were the related factors for the discharge with tube. Conclusion:In view of the above risk factors, it is beneficial for the physical and mental recovery of patients to pay attention to preoperative evaluation, make adequate preoperative preparation, postoperative nursing and observation, improve swallowing function training, prepare for discharge, pay attention to continuous nursing, and establish a tertiary hospital-community-family rehabilitation system.
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Objective@#To explore the main risk factors of hospital infection in children with hypospadias after operation and to formulate targeted nursing measures so as to provide accurate nursing strategies for effective prevention and control of hospital infection after operation.@*Methods@#Totally 383 children who underwent hypospadias surgery in the hospital from January 2016 to December 2017 were selected as the research objects. The clinical data of all cases were reviewed and sorted out. The hospital infection rate, infection site and main risk factors of hospital infection after operation were analyzed to formulate prevention strategies.@*Results@#71 of 383 children suffered from hospital infection, and the incidence rate of hospital infection was 18.5%.The distribution of infection sites was: respiratory tract infection in 30 cases, accounting for 42.25%;Urinary tract infection was found in 25 cases (35.21%). Incision infection was found in 14 cases (19.72%).Gastrointestinal infection occurred in 2 cases (2.82%). Logistic multivariate analysis showed that age, length of hospital stay after operation were closely related to hospital infection.@*Conclusions@#The major risk factors for postoperative nosocomial infection in children with hypospadias are age and postoperative hospital stay.Nursing measures: The hospital stay of children after operation can be shortened as much as possible by reminding and standardizing the routine maintenance of urinary catheter and strengthening the cooperation between doctors and nurses through charts. Strict implementation of visiting and accompanying system, good environmental control, strengthening hand hygiene, standardization of preoperative skin preparation and other nursing measures are adopted to protect children to the greatest extent.
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Objective To explore the main risk factors of hospital infection in children with hypospadias after operation and to formulate targeted nursing measures so as to provide accurate nursing strategies for effective prevention and control of hospital infection after operation. Methods Totally 383 children who underwent hypospadias surgery in the hospital from January 2016 to December 2017 were selected as the research objects. The clinical data of all cases were reviewed and sorted out. The hospital infection rate, infection site and main risk factors of hospital infection after operation were analyzed to formulate prevention strategies. Results 71 of 383 children suffered from hospital infection, and the incidence rate of hospital infection was 18.5% .The distribution of infection sites was: respiratory tract infection in 30 cases, accounting for 42.25% ;Urinary tract infection was found in 25 cases (35.21% ). Incision infection was found in 14 cases (19.72%).Gastrointestinal infection occurred in 2 cases (2.82%). Logistic multivariate analysis showed that age, length of hospital stay after operation were closely related to hospital infection. Conclusions The major risk factors for postoperative nosocomial infection in children with hypospadias are age and postoperative hospital stay.Nursing measures: The hospital stay of children after operation can be shortened as much as possible by reminding and standardizing the routine maintenance of urinary catheter and strengthening the cooperation between doctors and nurses through charts. Strict implementation of visiting and accompanying system, good environmental control, strengthening hand hygiene, standardization of preoperative skin preparation and other nursing measures are adopted to protect children to the greatest extent.
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Objective To explore the effect of specific nursing on quality of life of the parents of children with mental retardation (MR). Methods 160 parents of children with MR and 160 parents of normal children were evaluated with WHO Quality Of Life-BREF (WHO-QOL-BREF). The children with MR were divided into observation group (n=80) and control group (n=80). The control group received the traditional nursing care, and the observation group accepted specific nursing care. The scores of WHOQOLBREF were compared. Results The score of WHOQOL-BREF was lower in the MR group than in the normal group (P<0.01). The score decreased with the aggravation of MR (P<0.001). The score of WHOQOL-BREF was higher in the observation group than in the control group (P<0.01). Conclusion Specific nursing should be given to the parents of children with MR, which can promote their quality of life.
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Objective To explore the nursing risks on hemodialysis patients,and seek nursing countermeasures.Methods The quality and safety summaries from blood purification center of Sichuan Provincial People's Hospital (2009 to 2011,monthly) were studied.Nursing risk factors were firstly classified on the basis of adverse events which had occurred or had been avoided because of preventive measures.And then,a nursing risk management team was founded,and the main role of which was to analyze the cause and process of nursing risks,improve the process management and enhance nursing measures.Results Nursing skills and patients' satisfaction were obviously improved through strengthening the nursing risk management and training program.There were statistically significant differences between the indicators.Conclusions It can improve nursing skills and patients' satisfaction degree and reduce the occurrence of nursing risk by establishing risk management mechanism,culturing nursing stuffs risk awareness,paying more attention to detail management and continuous quality improvement.
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ObjectiveTo investigate the influencing factors for persevering in pelvic floor muscle exercise in puerperal women and nursing countenneasures.MethodsThe influencing factors for persevering in pelvic floor muscle exercise in 120 puerperal women before June 2010 were analyzed,and they were set as the control group.According to the analysis results,targeted nursing countermeasures were developed,comprehensive care approach that combined nursing intervention with health education were applied in 116 cases of puerperal women from June 2010 to June 2011,who were set as the observation group.The situation of recovery for maternal pelvic floor muscle tension was observed.ResultsThere were four main factors that affected maternal pelvic floor muscle exercise:pelvic floor muscle exercise is not inspected as post-natal visits items,obstetric nurses did not carry out necessary propaganda,did not understand the importance of pelvic floor muscle exercise and lack of knowledge among the puerperal women.The test results for pelvic floor muscle tension were as followed:in the observation group Ⅰ degree was in 9 cases,accounting for 7.76％; Ⅱ degree was in 31 cases,accounting for 26.72％; Ⅲ degree was in 76 cases,accounting for 65.52％.In the control group,I degree was in 35 cases,accounting for 29.17 ％; Ⅱ degree was in 44 cases,accounting for 36.67％; Ⅲ degree was in 41 cases,accounting for 34.17％.The recovery effect of pelvic floor muscle tension in the observation group was obviously better than the control group,the difference was significant.ConclusionsFactors influencing the puerperal women in persevering in pelvic floor muscle exercise was various,personalized care and intervention according to the influencing factors can improve compliance of pelvic floor muscle exercise for puerperal women,contribute to the recovery of pelvic floor muscle tension.